SP0114 case 1 presenter: imminent fracture risk: assessment and does IT help clinical management
Abstract
A 60 year old female was under long-term follow-up for rheumatoid arthritis, for which she took methotrexate. Ten years previously she had been found to have a single vertebral fracture and her fracture risk, assessed using The WHO Fracture Risk Assessment Tool (FRAX®), was calculated as a 13% risk of major osteoporotic fracture over the next 10 years. According to The National Osteoporosis Guideline Group (NOGG) recommendations, she underwent Dual X-ray Absorptiometry (DXA) which demonstrated a bone mineral density T-score of -1.7 at the femoral neck. Lifestyle, vitamin D and calcium intake were optimised and follow-up was arranged for 6 months. Prior to her next appointment she fell and sustained a fracture of the distal radius. On fracture liaison review her FRAX® risk of fracture was 14% (rising due to an increased year of age) despite the recent change in clinical circumstances. This case serves to emphasise the clinical conundra associated with imminent fracture risk (the 2 years after a fracture when the patient is at a significantly higher risk of fracture) and the difficulties with the decision to treat. Disclosure of Interests: None declared
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